Research on an innovative knee pain treatment that involves tiny electrical charges to the brain has received a boost with a five-year grant awarded recently to Hyochol “Brian” Ahn, PhD, at The University of Texas Health Science Center at Houston Cizik School of Nursing.
Ahn received a $2.4 million grant from the National Institute of Nursing Research (NINR) to study transcranial direct current stimulation (tDCS) combined with mindfulness-based meditation for home-based self-management of pain related to knee osteoarthritis in older adults.
“Finding a nonpharmacological approach is very important,” Ahn said. “Most of the pharmacological approaches produce side effects, addiction or tolerance problems.”
The success of massage, acupressure, and other nonpharmacological treatments focused on the knee itself have been limited. Instead, much of Ahn’s research looks at the effectiveness of stimulating the brain to reduce the perception of pain.
The severity of osteoarthritic conditions revealed by X-rays often doesn’t match the degree of pain reported by the patient, Ahn said. “Pain is their own perception,” he noted. “There is increased pain-related activation with osteoarthritis.”
The tDCS treatment can be considered “brain massage therapy,” Ahn said. The new grant will study applying technology to provide this treatment at home to older patients who may have mobility issues, and it will look at whether tDCS can improve the effectiveness of concurrent mindfulness meditation in easing pain.
The new grant builds on Ahn’s previous research and complements an on-going, three-year NIH/NINR-funded R15 study involving self-administered tDCS. On the strength of Ahn’s research and his proposal, the new grant was approved on its first submission.
Ahn will work with Kenneth Mathis, MD, an orthopedic surgeon with UT Physicians and an associate professor at McGovern Medical School at UTHealth, to make the study available to patients in his practice.
“This important study may provide further evidence that tDCS could eventually bring a drug-free pain relief modality to millions of patients worldwide and further reduce the need for opiate pain medication," Mathis said.
Two hundred patients will be recruited for the double-blind, randomized, sham-controlled study. Participants will be divided into four groups that will receive tDCS alone, mindfulness meditation alone, the two approaches combined, or a “sham” treatment that mimics but does not apply the combined treatment.
Patients will take home a small headgear device and a cellphone-sized device that connects to their computer, as well a guided meditation CD. A secure videoconferencing platform will be used to conduct 20-minute, at-home sessions five days a week, and patients will come into the office once a week for brain imaging to gauge the treatment’s effectiveness, Ahn said.
Ahn and his research team published a study in 2018 demonstrating the effectiveness of tDCS provided in the office setting.
“I believe we can do it in a virtual manner,” Ahn said. “A user-friendly home-based therapy would save time, effort, and money.”
An adult nurse practitioner, Ahn holds multiple degrees in electrical engineering and nursing. He has applied this varied background to establish a program of clinical and translational research that enhances health and independence in older adults using innovative technologies to optimize pain management. He is the Theodore J. and Mary E. Trumble Professor in Aging Research at Cizik School of Nursing at UTHealth.
“I am so proud of the determination of our research faculty and honored to be part of our research department, where the depth and breadth of our research is significantly expanding,” said Constance Johnson, PhD, associate dean and Maria C. and Christopher J. Pappas Family Distinguished Chair in Nursing of the Cizik School of Nursing’s research department. “Dr. Ahn has certainly made a large contribution to our growth.”